Musculoskeletal disorders (MSD) impose a growing societal burden. Although many new therapeutic options are available, questions on effectiveness, efficiency, and equity of care remain unanswered. This is reflected by the inclusion of the major MSDs of arthritis and metabolic bone disease as the theme for our CERTs. MSDs exert an especially heavy toll on the elderly and other disadvantaged and underserved subpopulations, including racial/ethnic minorities, children, &persons with co-morbidities. Study of these groups constitutes our sub-theme. During past AHRQ funding, we conducted >50 projects creating new knowledge and products, disseminating findings, and improving public health. The specific aims of the proposed Deep South Arthritis and Musculoskeletal (DSAM) CERTs are to: 1) Improve safety and effectiveness of MSD therapeutics through 4 projects (partners in parentheses) that build on our past work and address the programmatic areas of comparative effectiveness research (CER), tool development, health systems interventions and translating research into practice. These projects, which will directly impact patient outcomes dung this period of funding, include: (a) Comparative Effectiveness of NSAIDs vs. Narcotics after Joint Replacement Surgery (FORCE registry &UMass)- will lead to more effective and safer use of analgesics post-arthroplasty;(b) A Novel Tool and Multi-Modal Intervention for Improving Osteoporosis Treatment Adherence (Kaiser)- will increase therapeutic adherence among those at highest risk for non-adherence (will lead to lower rate of fractures);(c) Informed Consent Tools for Pragmatic Clinical Trials in Musculoskeletal Diseases (CMTP &JHU)- will yield tools for future important efforts in CER;and (d) Assessing Comparative Effectiveness of Biologics and Communicating Risk in Juvenile and Adult Inflammatory Arthritis (CARRA and Yale U)- will generate knowledge about risks of biologist and more effectively communicate risk leading to better arthritis outcomes;2) Educate health care practitioners, patients, caregivers, pavers, and policy makers while implementing and disseminating our research and educational portfolio;and 3) Develop concept briefs and other nascent research and education ideas into full scale projects and products for dissemination in cooperation with AHRQ, the CERTs Scientific Forum, and our large network of partners. With our talented investigator pool and through our Cores, we provide the infrastructure and proven expertise to successfully carryout this multi-disciplinary program of hypothesis testing research and tool development to improve regional and national MSD health care quality. PUBLIC HEALTH RELEVANCE: Arthritis and other musculoskeletal disorder impose to a growing societal burden. Although many new therapies are available, many questions on their effectiveness and safety remain unanswered. To improve patient outcomes and public health, the UAB Deep South Arthritis and Musculoskeletal CERTs will conduct research and develop products to answer questions and fill other unmet needs in this critical area